Maternal and Perinatal Outcome of Hypertensive Disorders of Pregnancy at a Tertiary Care Hospital
Keywords:
Pre eclampsia, eclampsia, maternal mortalityAbstract
Objective: To study the frequency of various hypertensive disorders of pregnancy and to determine their maternal and perinatal outcome.
Study Design: Retrospective descriptive study.
Place and Duration of Study: Department of Obstetrics & Gynecology Unit III, Civil Hospital Karachi, from January 2002 to December 2007.
Patients and Methods: A total of 626 cases were reviewed for age, parity, gestational age, diagnosis, antenatal and intra partum complications, mode of delivery and neonatal outcome. Data was analyzed using SPSS software (version 16).
Results: Total number of deliveries during the study period was 11,718 and there were 626 cases of hypertensive disorders of pregnancy giving a frequency of 5.34%. Pre-eclampsia was seen in 308 (49%), severe pre-eclampsia in 85 (13%), eclampsia in 121 (19.2%), chronic hypertension in 41(6%) and postpartum eclampsia in 21 (3.3%) patients. There were 39 maternal deaths (case fatality rate: 6.23%). The mean ages for pre-eclampsia, severe pre-eclampsia, eclampsia and chronic hypertension were 28, 27, 24 and 29 (27 years) years respectively. The commonest maternal complication of hypertensive disorders was postpartum hemorrhage in 24 women (4.2%). This was followed by placental abruption in 9 women (1.6%) and pulmonary edema in 8 women (1.4). The prevalence of prematurity in pre-eclampsia, severe pre-eclampsia and eclampsia in study population was 14%,
5% and 8.6% respectively.
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References
Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in
Pregnancy. Am J Obstet Gynecol 2000; 183:1-22.
Moodley J. Maternal deaths due to hypertensive disorders in pregnancy. Best Pract Res Clin Obstet Gynaecol 2008; 22:559-67.
Rochat RW, Koonin LM, Atrash HK, Jewett JF. Maternal mortality in the United States: report from the Maternal Mortality Collaborative. Obstet Gynecol 1988; 72:91-7.
Jafarey SN. Maternal mortality in Pakistan--compilation of available data. J Pak Med Assoc 2002; 52:539-44.
Shah N, Hossain N, Shoaib R, Hussain A, Gillani R, Khan NH. Socio-demographic Characteristics and the Three Delays of Maternal Mortality. J Coll Physicians Surg Pak 2009; 19:95-8.
Korejo R, Bhutta S, Noorani KJ, Bhutta ZA. An audit and trends of perinatal mortality at the Jinnah Postgraduate Medical Centre, Karachi. J Pak Med Assoc 2007; 57:168-72.
Geographic variation in the incidence ofhypertension in pregnancy. World Health Organization International Collaborative Study of Hypertensive Disorders of Pregnancy. Am J Obstet Gynecol 1988; 158:80-3.
CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364
pregnant women. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group. Lancet 1994; 343:619-29.
Rey E, Garneau P, David M, Gauthier R, Leduc L, Michon N, et al. Dalteparin for the prevention of recurrence of placental-mediated complications of pregnancy in women without thrombophilia: a pilot randomized controlled trial. J Thromb Haemost
; 7:58-64.
Urban G, Vergani P, Tironi R, Ceruti P, Vertemati E, Sala F, et al. Antithrombotic prophylaxis in multiparous women with preeclampsia or intrauterine growth retardation in an antecedent pregnancy. Int J Fertil Womens Med 2007; 52:59-67.
Papageorghiou AT, Leslie K. Uterine artery Doppler in the prediction of adverse pregnancy outcome. Curr Opin 0bstetGynecol2007; 19:103-9.
ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. ObstetGynecol. 2002; 99:159-67.
Sultana R, Bashir R. Khan B. Presentation and management outcome of Eclampsia at Ayub Teaching Hospital, Abbottabad. J Ayub Med Coll Abottabad 2005; 17:59-62.
Lain KY, Roberts JM. Contemporary concepts of the pathogenesis and management of preeclampsia. JAMA 2002;287:3183-6.
Rustveld LO, Kelsey SF, Sharma R. Association between maternal infections and preeclampsia: a systematic review of epidemiologic studies. Matern Child Health J 2008; 12:223-42.
Conde-Agudelo A, Villar J, Lindheimer M. Maternal infection and risk of preeclampsia: systematic review and metaanalysis. Am J Obstet Gynecol 2008; 198:7-22.
Matthys LA, Coppage KH, Lambers DS, Barton JR, SibaiBM. Delayed postpartum preeclampsia: an experience of 151 cases. Am J Obstet Gynecol 2004; 190:1464-6.
Gofton EN, Capewell V, Natale R, Gratton RJ. Obstetrical intervention rates and maternal and neonatal outcomes of women with gestational hypertension. Am J Obstet Gynecol 2001; 185:798-803.
Sibai BM, el-Nazer A, Gonzalez-Ruiz A. Severe preeclampsia-eclampsia in young primigravid women: subsequent pregnancy outcome and remote prognosis. Am J Obstet Gynecol 1986; 155:1011-6.
Manten GT, Sikkema MJ, Voorbij HA, Visser GH, Bruinse HW, Franx A. Risk factors for cardiovascular disease in women with a history of pregnancy complicated by preeclampsia or intrauterine growth restriction. Hypertens Pregnancy 2007; 26:39-50.
Newstead J, von Dadelszen P, Magee LA. Preeclampsia and future cardiovascular risk. Expert Rev Cardiovasc Ther 2007; 5:283-94.
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